Global Burden of Disease

health

A healthy population is a productive one.  Disease, malnutrition, sanitation and other public health concerns are central to the development of a region and to the productive capacity of a population.  With the advancement of technology, increased availability of drugs and improved governance, death by communicable disease has decreased and average life expectancy globally has increased by slightly more than ten years overall since 1970.  These gains, however, have not been evenly distributed across the world.  In terms of public health, these gains are partially offset by other rising challenges, and some regions are actually worse off today than twenty years ago.

The Lancet, a weekly general medical journal, published a comprehensive global study on the global burden of disease with many empirical findings.  The Global Burden of Disease Study 2010 “is the largest ever systematic effort to describe the global distribution and causes of a wide array of major diseases, injuries, and health risk factors”.  Here are some key insights:

  • Despite an average increase in life expectancy globally, the number of healthy years lost to disability has also increased.  So, although progress has been made in fighting fatal disease, little to no progress has been made in fighting non-fatal disease.  As a result, many of the extra years of life described by an increased life expectancy are spent in illness and injury.  This has a direct impact on health care expenditures and planning.
  • The top ten1 most burdensome global diseases are more common in men than in women, as described in this article of the study (free registration required).  Sarah Hawkes, a public health scholar at the University College London, discusses the impact of gender norms on men’s health outcomes in a recent Project Syndicate article, pointing out how public policy initiatives are disproportionately focused on women and mothers.  More gender equity in health policy initiatives can help alleviate the burden of global diseases that men often suffer from at a higher rate than women.
  • There has been a large shift from communicable, maternal and nutritional causes of death towards non-communicable diseases, except in sub-Saharan Africa.  In addition to this shift, regional variations exist in many causes of death, such as violence, suicide, diabetes, melanoma and others.  These regional differences can be very large: communicable, maternal, neonatal, and nutritional causes still accounted for 76 percent of premature mortality in sub-Saharan Africa in 2010.   Such variation by region highlights the importance of sound epidemiological assessments of the causes of death to better target public health efforts.

The Institute for Health Metrics and Evaluation has an interactive data visualization for they key data and figures from the study, available here.

Footnote 1:  High blood pressure, tobacco smoking (including second-hand smoke), household air pollution from fossil fuels, diet low in fruits, alcohol use, high body-mass index, high fasting plasma glucose, childhood underweight, ambient particulate matter pollution, physical inactivity and low physical activity.  Source: “A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990—2010: a systematic analysis for the Global Burden of Disease Study 2010”, Figure 5.

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One comment

  1. Great post. I find it so telling that one of the graphs from the IHME shows that Major Depressive disorder has been in the top 20 health conditions to contribute to DALYs and yet we hardly hear about any mental health care initiatives. Non-communicable diseases (including mental health conditions) will be the forefront of the next decades global health efforts, no doubt.

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